上海某社区老年认知与情绪问题干预的随访研究  

Mild cognitive impairment and emotional problems among the elderly in a community of Shanghai,China:A follow-up study

作　　者：张静洁[1] 鞠康[1] 陈思路[1] ZHANG Jingjie;JU Kang;CHEN Silu(Shanghai Changning Mental Health Center,Affiliated Mental Health Center of East China Normal University,Shanghai 200335,China)

机构地区：[1]上海市长宁区精神卫生中心(华东师范大学附属精神卫生中心),上海200335

出　　处：《中风与神经疾病杂志》2025年第2期159-164,共6页Journal of Apoplexy and Nervous Diseases

基　　金：上海市长宁区科学技术委员会科研课题项目(KW2020Y32);上海市卫生健康委员会科研课题项目(202040500)。

摘　　要：目的本研究探讨社区老年人群轻度认知功能障碍(MCI)、情绪问题(焦虑、抑郁)的筛查与干预。方法本研究采用抑郁症筛查量表(PHQ-9)、痴呆早期筛查量表(AD-8)、蒙特利尔认知评估量表(MoCA)、广泛性焦虑量表(GAD-7)、老年抑郁量表(GDS-15)、日常生活能力评定量表(ADL)对上海市某区老人轻度认知障碍(MCI)、情绪问题进行调查,采用t检验、Spearman相关系数分析以及线性回归分析方法,进行相关保护因素及综合干预措施效果评价。结果第一次干预使得认知障碍的病情有好转(P<0.001)。在第一次干预中,运动锻炼与技能训练对改善认知功能障碍非常有效(r=0.71,r=0.68,P<0.001),而集体授课与发放宣传材料的效果并不理想。第二次干预对认知障碍的病情依旧有显著效果(P<0.050)。第二次干预整体对于抑郁症的效果都并不明显,但技能训练依旧是效果最好的干预方式(Pr=0.0344,P<0.050)。研究结果显示2次社区随访干预措施,在轻度认知障碍、抑郁问题具有保护因素,对焦虑无缓解作用。结论随访干预措施验证了老年轻度认知障碍患者认知功能改善的有效性。对今后在社区层面,开展老年痴呆和轻度认知损害早期筛查、预测和随访干预,提供科学的预测和参考依据。Objective To investigate the public health issues associated with the follow-up outcomes of mental health in elderly community residents with a focus on mild cognitive impairment(MCI)and emotional problems(anxiety and depression),as the burden of various diseases increases with global population growth and aging.Methods In this study,Patient Health Questionnaire-9,Early Dementia Screening Scale,Montreal Cognitive Assessment,Generalized Anxiety Disorder Scale,Geriatric Depression Scale,and Activities of Daily Living scale were used to analyze the data on MCI and emotional problems among the elderly in a district of Shanghai,China.The t-test,Spearman correlation analysis,and linear regression analysis were used to identify related protective factors and evaluate the effectiveness of comprehensive intervention measures.Results The first session of intervention led to an improvement in cognitive impairment(P<0.001).During the first session of intervention,exercise and skill training were very effective in improving cognitive impairment(r=0.71 and 0.68,P<0.001),while group instruction and the distribution of educational materials failed to achieve an ideal effectiveness.The second session of intervention also had a significant effect on cognitive impairment(P<0.05);however,the second session of intervention lacked a significant overall effect,and skill training remained the most effective intervention method(Pr=0.0344,P<0.05).The research findings showed that the two sessions of community intervention were protective factors against MCI and depression,while they could not alleviate anxiety.Conclusion This study validates the effectiveness of follow-up intervention measures in improving cognitive function in elderly patients with MCI,which provide scientific prediction and reference for early screening,prediction,and follow-up intervention of elderly dementia and MCI at the community level.

关 键 词：轻度认知障碍 情绪问题 随访干预 预测 

分 类 号：R749.16[医药卫生—神经病学与精神病学]